A Practice Focused On Payors: At The Intersection Of Healthcare Plans And Governmental Contracting And Regulatory Work

Editor: Ms. Powell-Woodson, would you tell our readers something about your background and professional experience?

Powell-Woodson: I have been practicing for 25 years. Over that time I have practiced in a number of different venues. I served as an Assistant Attorney General for the Commonwealth of Virginia in the 1980s. Among the areas of my practice were representing the Procurement Appeals Board and the Department of Information Technology. From those representations I was able to develop a real understanding of procurement law.

I then served as in-house counsel to three healthcare companies, including (what was then) Blue Cross and Blue Shield of Virginia and Value Behavioral Health. Those experiences were valuable in developing an understanding of healthcare law and appreciating the considerations and pressures faced by in-house counsel on the legal, business, and financial fronts. In my current practice I have been able to bring the skills I developed as a manager of a corporate legal department to my relationships with our clients' corporate counsel. I also was appointed by Governor Doug Wilder of Virginia to serve in his administration as the director of the state agency that, among other responsibilities, oversaw the health benefits program for state employees and retirees. My current practice, which is focused principally on the intersection of healthcare and government contracting, draws upon these varied experiences.

Editor: You mentioned your experience as both in-house and outside counsel. I am sure this gives you an important perspective.

Powell-Woodson: My in-house experience has been invaluable to me at the firm. When you join your first law firm as I did after 17 years of practice in other settings, you bring perceptions and perspectives to the table regarding the role of outside counsel that those who have spent their entire career as law firm lawyers might not share. For example, I fully understand limitations on a client's legal budget and the pressures to manage outside counsel fees. Knowing how general counsel and the members of a corporate legal department think is a great spur to maximizing firm resources efficiently.

Editor: How did you come to Wiley Rein? What were the things that attracted you to the firm?

Powell-Woodson: I was at another firm before joining Wiley Rein. One of the factors that attracted me to Wiley was the breadth and diversity of its practice areas. While my healthcare practice was rooted largely in a government contracts posture, my clients were requesting more full-service capability. Therefore, I felt the need to find a firm with some of the practice areas they were seeking, such as labor law and intellectual property, as well as provide a corporate transactional platform. Wiley Rein was able to offer capacity in all of these areas - and more - and I was able to offer the firm additional depth of expertise in its healthcare practice. It was a meeting of the minds.

Editor: How has your practice evolved over the course of your career?

Powell-Woodson: One of the constants in my practice over the course of my career has been a focus on healthcare plans. That remains the case here at Wiley Rein. Many law firm healthcare practices are focused on representing providers and (to some degree) health plans. My practice, on the other hand, has been almost exclusively focused on the health plan side. In the past, I represented clients largely on state procurement matters and on regulatory issues arising out of state departments of insurance oversight. Today, my practice has evolved so that I am principally focused on the intersection of healthcare and those federal healthcare programs regulated by federal agencies.

Editor: Would you give us an overview of the firm's health care practice? For starters, what is the origin of the practice?

Powell-Woodson: One of the aspects of the Wiley Rein practice that I found very compatible with my own is that it too has always focused mainly on the representation of health plans. With our three partners, two full-time associates and another associate who devotes a significant amount of time to the healthcare practice, we provide a full-service practice addressing health plan issues. These issues include health care procurement, contract negotiation, and contract administration; regulatory counseling on all government healthcare programs; counseling on information privacy and security issues; representations on corporate compliance and healthcare fraud matters; and the defense of false claims allegations and the prosecution of those who defraud our clients. Our healthcare practice is as broad as any health plan-focused practice can be.

In addition to our full-time healthcare lawyers, we are in the enviable position of being able to call upon all of the firm's resources - in terms of expertise and personnel - on an ongoing basis. At any given time we will have several government contract attorneys working with us on procurement or contract administration issues, and we have corporate transactional lawyers who work with us on our clients' healthcare deals. In addition to the government contracts and corporate transactional attorneys, we are developing an increasing reliance on the firm's IP expertise and labor and employment practice.

Editor: Who are the clients?

Powell-Woodson: We represent national and regional health insurance companies, including many Blue Cross and Blue Shield plans, irrespective of their location.

Editor: Please tell us about the specialized areas within the practice.

Powell-Woodson: For the Medicare, Medicaid, the Federal Employees Health Benefits, and TRICARE programs, we provide specialized procurement, contracting, and contracts administration counseling. Our representations in these areas might include the defense or prosecution of protests; the development and negotiation of prime contracts and subcontracts; and the filing of claims or requests for equitable adjustments during contract performance. We also have a strong focus on regulatory counseling, and have established a well-recognized practice handling information privacy and security matters. We also have established a robust practice providing counseling on healthcare fraud and corporate compliance, as well as representing health plans in determining their disclosure and reporting obligations when there have been or will be mergers or acquisitions.

Editor: What are the central issues, and the trends, in health care law today?

Powell-Woodson: The healthcare industry continues to focus on the privacy and security of health information, both within their companies and also among domestic and off-shore subcontractors to whom they might disclose such information. As we move ever more dramatically into the electronic world, these issues remain a central focus.

There is greater competition for healthcare contacts with respect to federal health care programs. For example, the Medicare program, through its Medicare Administrative Contractor reform, has begun competing contracts that historically were awarded without competition. As a result, there is a greater need among healthcare companies and their lawyers to understand the complexities of competing in the highly regulated world of federal government contracting.

There also remains an intense focus on the government's scrutiny of contractor compliance in an effort to root out fraud and abuse.

Editor: Any thoughts on a national healthcare plan?

Powell-Woodson: Given the way in which our healthcare system is structured today, getting to a system where there is healthcare for all will require considerable sustained effort over a long period of time.

I certainly recognize that there are a number of problems in the system presently in place. It is very complicated, and that makes it difficult for people to negotiate. Also, for many people healthcare benefits are coupled with employment; so decoupling healthcare from employment will require a change of mindset. The new Massachusetts model that requires all residents to purchase health insurance or face legal penalties might prove to be a prototype for other states, although there does not appear to be sufficient traction at this time for such a model to serve as the basis for a national healthcare system. Also, what might work at the state level is not necessarily appropriate for the national level. The magnitude of attempting to provide, regulate, and pay for healthcare at the national level is something that would be difficult for a state-based model, however successful, to anticipate. In addition, there does not now seem to be a willingness to rethink the ways in which healthcare is provided, regulated, and paid for at the national level. My reaction is that in the next few years we will see a number of small but measurable steps aimed at making the present system more efficient and more accessible, but no major overhaul of the current model.

Editor: Where would you like to see Wiley Rein's healthcare practice in, say, five years?

Powell-Woodson: We have been able to develop a broad-based, health-plan focused healthcare practice. I would like to see our practice group expand so that there are more attorneys dedicated to working on the varied matters we now handle. Our challenge is to find healthcare attorneys who share our appreciation that we will not try to be all things to all people in the healthcare arena. I think that is the right decision for us, and I have every expectation that we will become known as a firm with one of the finest health plan practices in the country.